安罗替尼联合PD⁃1/PD⁃L1抑制剂后线治疗晚期转移性结直肠癌的临床观察

Clinical observation of anlotinib combined with PD⁃1/PD⁃L1 inhibitor retroline treatment of advanced metastatic colorectal cancer

目的探讨安罗替尼联合PD⁃1/PD⁃L1抑制剂后线治疗晚期结直肠癌的临床疗效与安全性。方法选取2020年2月至2020年10月衡水市人民医院收治的既往曾接受三线及以上标准治疗的晚期转移性结直肠癌患者17例,给予患者盐酸安罗替尼胶囊联合PD⁃1/PD⁃L1抑制剂治疗,根据RECIST 1.1版标准和NCI CTC 4.0版标准评价疗效及不良反应。结果17例患者至随访结束死亡1例,其余16例没有获得完全缓解,2例部分缓解、6例稳定和8例进展,有效率和疾病控制率分别为11.76%和47.06%。中位随访时间为2.1个月。最常见不良反应为高血压、疲劳、腹泻,发生率依次为35.30%(6/17)、35.30%(6/17)、29.41%(5/17)。绝大多数不良反应为1~2级,未出现4级不良反应。结论安罗替尼联合PD⁃1/PD⁃L1抑制剂后线治疗晚期结直肠癌具有良好的效果与安全性,可在临床上应用。

Objective To investigate the clinical efficacy and safety of anlotinib combined with PD-1/PD-L1 inhibitor in the treatment of metastatic colorectal cancer. Methods 17 patients with metastatic colorectal cancer admitted to Hengshui People ’ s Hospital from February 2020 to October 2020 who had previously received standard treatment of third-line or above were treated with Anlotinib hydrochloride capsule combined with PD-1/PD-L1 inhibitor. The efficacy and adverse reactions were evaluated according to RECIST1.1 and NCI CTC 4.0,and the prognostic factors were analyzed according to the follow-up data. Results One of the 17 patients died at the end of follow-up,the remaining 16 patients did not achieve complete remission,2patients had partial response,6 patients were stable,and 8 patients progressed,and the effective rate and disease control rate were 11.76% and 47.06%,respectively. The median follow-up time was 2. 1 months. The most common adverse reactions were hypertension(35.30%,6/17),fatigue(35.30%,6/17)and diarrhea(29.41%,5/17). The vast majority of adverse reactions were grade 1 to 2,and no grade 4 adverse reactions occurred. Conclusion Anlotinib combined with PD-1/PD-L1 inhibitor has good efficacy and safety in the treatment of advanced colorectal cancer and can be used clinically.